Why choose articaine over lidocaine for the removal of third molars? Systematic review and meta-analysis.

Background: The aim of the present study was to seek scientific evidence through a systematic review and meta-analysis for the choice of articaine over lidocaine in the removal of third molars.

Material And Methods: Searches were performed of the MEDLINE/PubMed, EMBASE, Cochrane Library (CENTRAL), Web of Science, and SCOPUS databases as well as the grey literature.

Results: Four hundred three articles were found, only 14 of which met the eligibility criteria. A total of 1114 third molars were removed: 557 with articaine and 557 with lidocaine. Articaine had a higher success rate than lidocaine (RR = 1.09, 95% CI: 1.03 to 1.15; < 0.05), shorter subjective latency time (MD = -15.10, 95% CI: -21.57 to -8.63; < 0.05), less intraoperative pain (MD = -6; < 0.05), longer duration (MD = 68.86; < 0.05), and less postoperative pain (MD = -3.05; < 0.05).

Conclusions: Based on the findings, articaine is superior to lidocaine for use in lower third molar surgeries due to the higher success rate, shorter time until the onset of action, greater control of intraoperative and postoperative pain, and longer duration of the anesthetic effect. Articaine, lidocaine, third molar, impacted teeth.